Drug dosing in patients with renal insufficiency

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When drugs are prescribed for patients with renal insufficiency, the dosage regimen may need to be altered to prevent toxic accumulation of drugs or their metabolites. An increase in the dosing interval is preferred over dose reduction for drugs excreted by the kidney. In this article, the authors explain how renal impairment interferes with the disposition of drugs and present guidelines to reduce drug-induced side effects and improve patient outcomes.

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Notes on contributors

George L. Bakris

George L. Bakris, MD Robert Talbert, PharmD Dr Bakris (pictured) is assistant professor, departments of preventive and internal medicine, divisions of nephrology and endocrinology, Rush-Presbyterian-St Luke's Medical Center, Chicago. He is also director of the Hypertension Research Fellowship Program at Rush University Hypertension Center.

Dr Talbert is professor, college of pharmacy, University of Texas at Austin, and professor, departments of medicine and pharmacology, University of Texas Health Science Center at San Antonio, where he is also head of the division of clinical pharmacy.

Robert Talbert

George L. Bakris, MD Robert Talbert, PharmD Dr Bakris (pictured) is assistant professor, departments of preventive and internal medicine, divisions of nephrology and endocrinology, Rush-Presbyterian-St Luke's Medical Center, Chicago. He is also director of the Hypertension Research Fellowship Program at Rush University Hypertension Center.

Dr Talbert is professor, college of pharmacy, University of Texas at Austin, and professor, departments of medicine and pharmacology, University of Texas Health Science Center at San Antonio, where he is also head of the division of clinical pharmacy.